| NPI | 1336597970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB11120500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 298779) |
| 207R00000X Internal Medicine (Licence: IL 125.068636) | |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2021-07-14 |